NUR 272 FINAL EXAM REVIEW QUESTIONS & CORRECT
ANSWERS WITH DETAILED RATIONALES NEW 2026-2027
UPDATE COMPLETE NURSING EXAM STUDY GUIDE
95 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply evidence-based clinical judgment to prioritize care for patients with complex, multisystem health
alterations
2 Analyze pharmacologic, pathophysiologic, and technological data to make safe, patient-centered
decisions
3 Integrate quality improvement, leadership, and population health principles into professional nursing
practice
4 NUR 272 Final Exam Review Questions & Correct Answers with Detailed Rationales New 2026
5 2027 Update Complete Nursing Exam Study Guide
6 Foundations of Nursing - Medical-Surgical, Critical Care, Pharmacology, Maternal/Newborn, Pediatrics,
Mental Health, Community Health, Leadership, Informatics
7 Applied Nursing - Medical-Surgical, Critical Care, Pharmacology, Maternal/Newborn, Pediatrics, Mental
Health, Community Health, Leadership, Informatics
8 Advanced Nursing - Medical-Surgical, Critical Care, Pharmacology, Maternal/Newborn, Pediatrics, Mental
Health, Community Health, Leadership, Informatics
9 Nursing - Medical-Surgical, Critical Care, Pharmacology, Maternal/Newborn, Pediatrics, Mental Health,
Community Health, Leadership, Informatics Review
ABSTRACT
Page 1
,This study document brings together 95 carefully worded exam questions drawn from NUR 272
Final Exam Review Questions & Correct Answers with Detailed Rationales New 2026-2027 Update
Complete Nursing Exam Study Guide, with the strongest emphasis placed on Apply
evidence-based clinical judgment to prioritize care for patients with complex, multisystem health
alterations, Analyze pharmacologic, pathophysiologic, and technological data to make safe,
patient-centered decisions, Integrate quality improvement, leadership and and population health
principles into professional nursing practice. Every item follows the wording style and level of
reasoning you meet in the real paper, and each one is paired with a clear rationale so the correct
choice is never a guess. Work through the set at your own pace, mark the questions that slow you
down, then come back to them until the reasoning feels automatic. Learners who revise this way
walk into the exam room recognising the pattern behind the questions instead of meeting them for
the first time. Keep going - steady, honest practice is what turns a difficult paper into a comfortable
pass.
Q1 APPLY EVIDENCE-BASED CLINICAL JUDGMENT TO PRIORITIZE CARE FOR PATIENTS
WITH COMPLEX, MULTISYSTEM HEALTH ALTERATIONS
A patient with septic shock has been resuscitated with 30 mL/kg of crystalloid and
is now on norepinephrine at 0.4 mcg/kg/min. Which finding best indicates that the
patient is transitioning from the 'C' (circulatory) to the 'H' (hypoperfusion) phase of
sepsis-induced organ dysfunction?
A. Central venous oxygen saturation (ScvO2) rising from 58% to 72%
B. Serum lactate rising from 2.1 to 4.6 mmol/L despite normalized mean arterial pressure
CORRECT
C. Urine output increasing from 0.3 to 0.9 mL/kg/hr
D. Capillary refill decreasing from 4 seconds to 2 seconds
RATIONALE: Rising lactate despite normalized MAP reflects ongoing tissue hypoperfusion
(cryptic shock) and progression to the hypoperfusion/organ dysfunction phase of sepsis. The
other options represent improving perfusion (ScvO2, urine output, capillary refill) and do not
indicate deterioration.
Page 2
,Q2 APPLY EVIDENCE-BASED CLINICAL JUDGMENT TO PRIORITIZE CARE FOR PATIENTS
WITH COMPLEX, MULTISYSTEM HEALTH ALTERATIONS
A nurse is analyzing a unit's quality dashboard. The central line-associated
bloodstream infection (CLABSI) rate is 2.1 per 1,000 catheter-days, up from 0.8.
Which action best reflects the 'Check' phase of the PDSA cycle?
A. Implementing a new chlorhexidine bathing protocol for all ICU patients
B. Comparing observed CLABSI rates against national benchmarks and reviewing compliance
audits CORRECT
C. Educating staff on maximal sterile barrier precautions during insertion
D. Standardizing the central line insertion bundle across all units
RATIONALE: The 'Check' phase involves analyzing data and comparing results to benchmarks to
evaluate whether the intervention worked. Implementing, educating, and standardizing are 'Plan'
or 'Do' phase activities.
Q3 APPLY EVIDENCE-BASED CLINICAL JUDGMENT TO PRIORITIZE CARE FOR PATIENTS
WITH COMPLEX, MULTISYSTEM HEALTH ALTERATIONS
A patient receiving continuous IV amiodarone develops a heart rate of 42 bpm,
blood pressure 78/44 mm Hg, and a new junctional rhythm. Which is the priority
nursing action?
A. Administer atropine 0.5 mg IV push
B. Stop the amiodarone infusion and notify the provider CORRECT
C. Increase the infusion rate to stabilize the rhythm
D. Prepare for synchronized cardioversion
RATIONALE: Amiodarone can cause symptomatic bradycardia and hypotension; the priority is to
stop the offending infusion and notify the provider. Atropine may be used for symptomatic
bradycardia but does not address the cause; increasing the rate would worsen toxicity;
cardioversion is not indicated for bradycardia.
Page 3
, Q4 APPLY EVIDENCE-BASED CLINICAL JUDGMENT TO PRIORITIZE CARE FOR PATIENTS
WITH COMPLEX, MULTISYSTEM HEALTH ALTERATIONS
A laboring patient at 38 weeks' gestation has a Category II fetal heart tracing with
recurrent late decelerations. Which intrauterine resuscitation measure should the
nurse implement FIRST?
A. Administer oxygen at 10 L/min via nonrebreather mask
B. Reposition the patient to left lateral position CORRECT
C. Increase the IV oxytocin infusion rate
D. Prepare for immediate cesarean delivery
RATIONALE: Late decelerations indicate uteroplacental insufficiency; the first intervention is
maternal repositioning (left lateral) to improve uterine perfusion. Oxygen and IV fluids may follow,
but repositioning is the immediate priority. Oxytocin should be stopped, not increased; cesarean
is considered if measures fail.
Q5 APPLY EVIDENCE-BASED CLINICAL JUDGMENT TO PRIORITIZE CARE FOR PATIENTS
WITH COMPLEX, MULTISYSTEM HEALTH ALTERATIONS
A patient with major depressive disorder has been taking fluoxetine for 4 weeks
with minimal improvement. The provider adds mirtazapine. Which assessment
finding indicates a potential serotonin syndrome?
A. Increased appetite and weight gain
B. Clonus, hyperreflexia, and agitation CORRECT
C. Sedation and dry mouth
D. Orthostatic hypotension and dizziness
RATIONALE: Serotonin syndrome classically presents with neuromuscular excitability (clonus,
hyperreflexia), autonomic instability, and altered mental status. Increased appetite, sedation, dry
mouth, and orthostatic hypotension are common side effects of mirtazapine but do not indicate
serotonin syndrome.
Page 4
ANSWERS WITH DETAILED RATIONALES NEW 2026-2027
UPDATE COMPLETE NURSING EXAM STUDY GUIDE
95 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply evidence-based clinical judgment to prioritize care for patients with complex, multisystem health
alterations
2 Analyze pharmacologic, pathophysiologic, and technological data to make safe, patient-centered
decisions
3 Integrate quality improvement, leadership, and population health principles into professional nursing
practice
4 NUR 272 Final Exam Review Questions & Correct Answers with Detailed Rationales New 2026
5 2027 Update Complete Nursing Exam Study Guide
6 Foundations of Nursing - Medical-Surgical, Critical Care, Pharmacology, Maternal/Newborn, Pediatrics,
Mental Health, Community Health, Leadership, Informatics
7 Applied Nursing - Medical-Surgical, Critical Care, Pharmacology, Maternal/Newborn, Pediatrics, Mental
Health, Community Health, Leadership, Informatics
8 Advanced Nursing - Medical-Surgical, Critical Care, Pharmacology, Maternal/Newborn, Pediatrics, Mental
Health, Community Health, Leadership, Informatics
9 Nursing - Medical-Surgical, Critical Care, Pharmacology, Maternal/Newborn, Pediatrics, Mental Health,
Community Health, Leadership, Informatics Review
ABSTRACT
Page 1
,This study document brings together 95 carefully worded exam questions drawn from NUR 272
Final Exam Review Questions & Correct Answers with Detailed Rationales New 2026-2027 Update
Complete Nursing Exam Study Guide, with the strongest emphasis placed on Apply
evidence-based clinical judgment to prioritize care for patients with complex, multisystem health
alterations, Analyze pharmacologic, pathophysiologic, and technological data to make safe,
patient-centered decisions, Integrate quality improvement, leadership and and population health
principles into professional nursing practice. Every item follows the wording style and level of
reasoning you meet in the real paper, and each one is paired with a clear rationale so the correct
choice is never a guess. Work through the set at your own pace, mark the questions that slow you
down, then come back to them until the reasoning feels automatic. Learners who revise this way
walk into the exam room recognising the pattern behind the questions instead of meeting them for
the first time. Keep going - steady, honest practice is what turns a difficult paper into a comfortable
pass.
Q1 APPLY EVIDENCE-BASED CLINICAL JUDGMENT TO PRIORITIZE CARE FOR PATIENTS
WITH COMPLEX, MULTISYSTEM HEALTH ALTERATIONS
A patient with septic shock has been resuscitated with 30 mL/kg of crystalloid and
is now on norepinephrine at 0.4 mcg/kg/min. Which finding best indicates that the
patient is transitioning from the 'C' (circulatory) to the 'H' (hypoperfusion) phase of
sepsis-induced organ dysfunction?
A. Central venous oxygen saturation (ScvO2) rising from 58% to 72%
B. Serum lactate rising from 2.1 to 4.6 mmol/L despite normalized mean arterial pressure
CORRECT
C. Urine output increasing from 0.3 to 0.9 mL/kg/hr
D. Capillary refill decreasing from 4 seconds to 2 seconds
RATIONALE: Rising lactate despite normalized MAP reflects ongoing tissue hypoperfusion
(cryptic shock) and progression to the hypoperfusion/organ dysfunction phase of sepsis. The
other options represent improving perfusion (ScvO2, urine output, capillary refill) and do not
indicate deterioration.
Page 2
,Q2 APPLY EVIDENCE-BASED CLINICAL JUDGMENT TO PRIORITIZE CARE FOR PATIENTS
WITH COMPLEX, MULTISYSTEM HEALTH ALTERATIONS
A nurse is analyzing a unit's quality dashboard. The central line-associated
bloodstream infection (CLABSI) rate is 2.1 per 1,000 catheter-days, up from 0.8.
Which action best reflects the 'Check' phase of the PDSA cycle?
A. Implementing a new chlorhexidine bathing protocol for all ICU patients
B. Comparing observed CLABSI rates against national benchmarks and reviewing compliance
audits CORRECT
C. Educating staff on maximal sterile barrier precautions during insertion
D. Standardizing the central line insertion bundle across all units
RATIONALE: The 'Check' phase involves analyzing data and comparing results to benchmarks to
evaluate whether the intervention worked. Implementing, educating, and standardizing are 'Plan'
or 'Do' phase activities.
Q3 APPLY EVIDENCE-BASED CLINICAL JUDGMENT TO PRIORITIZE CARE FOR PATIENTS
WITH COMPLEX, MULTISYSTEM HEALTH ALTERATIONS
A patient receiving continuous IV amiodarone develops a heart rate of 42 bpm,
blood pressure 78/44 mm Hg, and a new junctional rhythm. Which is the priority
nursing action?
A. Administer atropine 0.5 mg IV push
B. Stop the amiodarone infusion and notify the provider CORRECT
C. Increase the infusion rate to stabilize the rhythm
D. Prepare for synchronized cardioversion
RATIONALE: Amiodarone can cause symptomatic bradycardia and hypotension; the priority is to
stop the offending infusion and notify the provider. Atropine may be used for symptomatic
bradycardia but does not address the cause; increasing the rate would worsen toxicity;
cardioversion is not indicated for bradycardia.
Page 3
, Q4 APPLY EVIDENCE-BASED CLINICAL JUDGMENT TO PRIORITIZE CARE FOR PATIENTS
WITH COMPLEX, MULTISYSTEM HEALTH ALTERATIONS
A laboring patient at 38 weeks' gestation has a Category II fetal heart tracing with
recurrent late decelerations. Which intrauterine resuscitation measure should the
nurse implement FIRST?
A. Administer oxygen at 10 L/min via nonrebreather mask
B. Reposition the patient to left lateral position CORRECT
C. Increase the IV oxytocin infusion rate
D. Prepare for immediate cesarean delivery
RATIONALE: Late decelerations indicate uteroplacental insufficiency; the first intervention is
maternal repositioning (left lateral) to improve uterine perfusion. Oxygen and IV fluids may follow,
but repositioning is the immediate priority. Oxytocin should be stopped, not increased; cesarean
is considered if measures fail.
Q5 APPLY EVIDENCE-BASED CLINICAL JUDGMENT TO PRIORITIZE CARE FOR PATIENTS
WITH COMPLEX, MULTISYSTEM HEALTH ALTERATIONS
A patient with major depressive disorder has been taking fluoxetine for 4 weeks
with minimal improvement. The provider adds mirtazapine. Which assessment
finding indicates a potential serotonin syndrome?
A. Increased appetite and weight gain
B. Clonus, hyperreflexia, and agitation CORRECT
C. Sedation and dry mouth
D. Orthostatic hypotension and dizziness
RATIONALE: Serotonin syndrome classically presents with neuromuscular excitability (clonus,
hyperreflexia), autonomic instability, and altered mental status. Increased appetite, sedation, dry
mouth, and orthostatic hypotension are common side effects of mirtazapine but do not indicate
serotonin syndrome.
Page 4
